A Pennsylvania worker who becomes ill or suffers an injury on the job may be entitled to benefits from the Pennsylvania workers’ compensation system. In some cases, a claim is approved in a short period of time, and the claimant sails through the system with no obstacles. More often, however, a claimant encounters a few bumps in the road to approval of a claim and receipt of benefits.
One of those bumps may be the need for mediation if your claim is initially denied. Here are some key questions and answers regarding mediation in the claims process:
Is Mediation Mandatory?
Section 401.1 of the Pennsylvania Workers’ Compensation Act states:
“Mediations shall take place no later than 30 days prior to the date set for filing proposed findings of fact and conclusions of law or legal briefs or memoranda unless, upon good cause shown, the workers’ compensation judge determines mediation would be futile.”
Although there are numerous reasons a judge might determine that mediation would be futile, the most common reason is that the attorney for the insurer or employer does not have authority to settle the case.
Who Is the Mediator?
A workers’ compensation judge will oversee the mediation of your case. This is not the same judge who is presiding over the case itself. Instead, the mediation judge will be appointed by the primary judge.
What Happens at Mediation?
The concept behind mediation is to put both sides together with a neutral party in the middle to help resolve outstanding issues. Typically, the injured worker and his or her attorney will be present along with the attorney for the employer’s insurance company and possibly a representative from the employer.
The attorneys often submit memorandums or briefs to the mediation judge prior to the actual mediation so that the judge is aware of the issues. At mediation, the judge will usually meet privately with each side to see what compromises can be worked out and what the deal breakers are. After that, the judge may bring both sides together to see if any, or all, of the issues can be resolved.
What If We Don’t Reach an Agreement at Mediation?
You are not required to reach an agreement through mediation. You could resolve some, all or none of the issues. You are not required to accept an offer made during mediation. The mediation judge will report to the workers’ compensation judge after the mediation is completed. If issues remain after mediation, either side may request an informal conference with the primary judge.
If you have suffered an injury or become ill as a result of your employment in Pennsylvania, you may be entitled to benefits through the Worker’s Compensation. Although the system is intended to protect injured workers and their families, it can be difficult to navigate. If you have questions or concerns about your legal rights to compensation, contact the workplace injury lawyers at Shor & Levin, the Bulldog Lawyers, at 866-462-8553 or use our online contact form.